Sentinel node mapping in female genital tract malignancy

Background: Lymphatic mapping and sentinel node identification, new to gynecologic malignancies represented one of advances, which among diseases, such as malignant melanoma and breast cancer, have radically altered classic surgical practices once deemed the final achievement of surgery. Integration of lymphatic mapping into triage and management has dramatically improved treatment precision by offering better disease characterization with the potential for reducing toxicity through less radical intervention. Developmental steps in refining the lymphatic mapping technique have promulgated by a need to simplify the procedure and to develop an effective intraoperative strategy enabling precise nodal identification and treatment triage in one step. The first compounds used in this progression were selective lymphotrophic dyes. Alternative mapping materials that have been successful include fluoroscein and patent blue-V. However, the former requires a dark room and is associated with tissue extravasations. The blue staining of a node with identification of at least one blue-stained afferent lymphatic channel entering the node remains the gold standard for assessment of whether a lymph node is or is not a true sentinel node. However, introduction of techniques, such as radioactive colloid injections and lymphoscintigraphy, have enhanced the accuracy of detecting the sentinel node. These have been particularly useful in identifying nodes outside of their routine anatomical landmarks of dissection and aiding the poorly or ambiguously.Objectives: The purpose of this work is sentinel node identification and introducing the concept of lymphatic mapping preoperatively and intraoperatively in the female genital tract malignancy.